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DATE <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />r� <br />TIME: Qc)o ' 7" CASE #: ) 5 6 q 90 <br />LOCATION (PARKJOPEN SPACE): MA (4 it I si 'rAC c, i I S -Aftie- <br />W 1911111 ililitT "IT915211! <br />V1117T M7 <br />notified that y u are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />110 <br />The basis fiat this Notice of Restriction of Use is that on you violated Section L 410*—Of the Park- <br />and 0 en Space Rules, and/or Section m of the Eugene Code, 1971, and/or ORS To wit, you: <br />p <br />e— <br />(Description of the violation.) k I I I I ) 1`5' and shall remain in effect until I <br />This restriction of use is effective beginnin g on 5 Y 1 1 - <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />I fie UIVIslorl I , I I "I'll 11 je a HIM alit lace jol Me 111101 I'll, - &, "' — 11 SIM T r, L Mu <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the infornial hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and tirne shown above by: <br />i PAC ( K)"Z-5 <br />(Signature ofperson issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: Fi [c Yc I I ow Copy � Report Copy Pink Copy: Pe-cipiknt Gold Copy: Officer Appeal notice Rev, 04103 <br />Name: Last First <br />DO <br />Race/S X. <br />63 <br />Res. Address: city <br />State <br />tMliddle <br />Zip <br />Z' p <br />Res, Phone: <br />WO (k 1 <br />W 1911111 ililitT "IT915211! <br />V1117T M7 <br />notified that y u are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />110 <br />The basis fiat this Notice of Restriction of Use is that on you violated Section L 410*—Of the Park- <br />and 0 en Space Rules, and/or Section m of the Eugene Code, 1971, and/or ORS To wit, you: <br />p <br />e— <br />(Description of the violation.) k I I I I ) 1`5' and shall remain in effect until I <br />This restriction of use is effective beginnin g on 5 Y 1 1 - <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />I fie UIVIslorl I , I I "I'll 11 je a HIM alit lace jol Me 111101 I'll, - &, "' — 11 SIM T r, L Mu <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the infornial hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and tirne shown above by: <br />i PAC ( K)"Z-5 <br />(Signature ofperson issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: Fi [c Yc I I ow Copy � Report Copy Pink Copy: Pe-cipiknt Gold Copy: Officer Appeal notice Rev, 04103 <br />